256层螺旋计算机断层摄影术测定的心外膜脂肪体积与心房颤动的相关性
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摘要
目的:探讨256层螺旋计算机断层摄影术(CT)测定的心外膜脂肪组织体积(EATV)与心房颤动(房颤)的相关性。方法:选择2016-09至2017-09我院收治的房颤患者66例作为房颤组,其中阵发性房颤患者42例,持续性房颤患者24例;同期入选70例窦性心律者作为窦性心律组。136例患者均行256层螺旋CT心脏成像,测量所有患者的EATV、房颤组患者的心周脂肪组织体积(PATV)。进一步对阵发性房颤患者与持续性房颤患者的EATV等进行统计分析。结果:房颤组患者的EATV大于窦性心率组[(138.94±37.93)ml vs(93.55±34.79)ml,P<0.001]。持续性房颤患者的EATV[(142.20±40.86)ml vs (137.07±36.53)ml]、PATV[(230.67±60.83)mlvs(223.56±60.62)ml]均高于阵发性房颤患者,但差异均无统计学意义(P>0.05)。房颤患者的EATV与PATV呈显著正相关(r=0.953,P<0.001)。多因素Logistic回归分析结果显示,EATV是房颤发生的独立相关危险因素(OR=1.143,95%CI:1.027～1.158),P=0.000)。结论:采用256层螺旋CT可以客观定量测量EATV,EATV与PATV显著相关,EATV的增加与房颤的发生密切相关,但不同类型房颤患者之间的EATV差异不显著。
Objectives: To explore the relationship between the 256 slice spiral CT-derived epicardial adipose tissue volume(EATV) and atrial fibrillation(AF). Methods: A total of 66 AF patients were enrolled and divided into 2 groups: paroxysmal AF group(n=42) and persistent AF group(n=24). In addition, 70 cases with sinus rhythm were enrolled as control group. 256 slice spiral CT was applied in these 136 patients,EATV in all patients and volume of pericardial adipose tissue(PATV) in patients with AF were measured. EATV value was compared between the paroxysmal AF group and persistent AF group.Results: EATV value was significantly higher in AF group than in control group([138.94±37.93] ml vs [93.55±34.79] ml, P<0.001). EATV([142.20±40.86] ml vs [137.07±36.53] ml) and PATV([230.67±60.83] ml vs [223.56±60.62] ml) values tended to be higher in persistent AF group than those in paroxysmal AF group(P>0.05). There was a significant positive correlation between EATV and PATV in AF group(r=0.953, P<0.001). Logisric regression anahysis indicted that EATV(OR=1.143, 95%CI: 1.027～1.158, P=0.000) was independenthy associated with AF.Conclusions: EATV can be objectively and quantitatively measured by 256 slice spiral CT. There is a significant positive correlation between EATV and PATV in AF group. The increase of EATV is closely related to the occurrence of AF. However, there is no significant difference in EATV between paroxysmal AF and persistent AF patients.
Objectives: To explore the relationship between the 256 slice spiral CT-derived epicardial adipose tissue volume(EATV) and atrial fibrillation(AF). Methods: A total of 66 AF patients were enrolled and divided into 2 groups: paroxysmal AF group(n=42) and persistent AF group(n=24). In addition, 70 cases with sinus rhythm were enrolled as control group. 256 slice spiral CT was applied in these 136 patients,EATV in all patients and volume of pericardial adipose tissue(PATV) in patients with AF were measured. EATV value was compared between the paroxysmal AF group and persistent AF group.Results: EATV value was significantly higher in AF group than in control group([138.94±37.93] ml vs [93.55±34.79] ml, P<0.001). EATV([142.20±40.86] ml vs [137.07±36.53] ml) and PATV([230.67±60.83] ml vs [223.56±60.62] ml) values tended to be higher in persistent AF group than those in paroxysmal AF group(P>0.05). There was a significant positive correlation between EATV and PATV in AF group(r=0.953, P<0.001). Logisric regression anahysis indicted that EATV(OR=1.143, 95%CI: 1.027～1.158, P=0.000) was independenthy associated with AF.Conclusions: EATV can be objectively and quantitatively measured by 256 slice spiral CT. There is a significant positive correlation between EATV and PATV in AF group. The increase of EATV is closely related to the occurrence of AF. However, there is no significant difference in EATV between paroxysmal AF and persistent AF patients.
引文
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[12]祁荣兴,李敏,龚沈初,等.64层螺旋CT测量心外膜脂肪体积:对测量结果的可重复性研究[J].放射学实践,2012,27(8):840-843.DOI:10.3969/j.issn.1000-0313.2012.08.007.
[2]Zhou Z,Hu D.An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China[J].JEpidemiol,2008,18(5):209-216.
[3]Tabl MA,Torky A,Farid A.The relation between total epicardial fat volume assessed by cardiac CT and the presence of atrial fibrillation[J].Egypt Heart J,2016,68(2):97-102.DOI:org/10.1016/j.ehj.2015.12.001.
[4]Camm AJ,Kirchhof P,Lip GY,et al.Guidelines for the management of atrial fibrillation:the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology(ESC)[J].Eur Heart J,2010,31(19):2369-2429.DOI:10.1093/eurheartj/ehq278.
[5]许键,何燕,罗蓓蓓,等.NLRP3炎症小体与心房颤动的相关性研究[J].中国循环杂志,2017,32(1):72-76.DOI:10.3969/j.issn.1000-3614.2017.01.017.
[6]Hatem SN,Sanders P.Epicardial adipose tissue and atrial fibrillation[J].Cardiovasc Res,2014,102(2):205-213.DOI:10.1093/cvr/cvu045.
[7]Ardell JL.The cardiac neuronal hierarchy and susceptibility to arrhythmias[J].Heart Rhythm,2011,8(4):590-591.DOI:10.1016/j.hrthm.2010.12.019.
[8]Singhal R,Lo LW,Lin YJ,et al.Intrinsic cardiac autonomic ganglionated plexi within epicardial fats modulate the atrial substrate remodeling:experiences with atrial fibrillation patients receiving catheter ablation[J].Acta Cardiologica Sinica,2016,32(2):174-184.
[9]Stojanovska J,Kazerooni EA,Sinno M,et al.Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome[J].Eur Radiol,2015,25(8):2298-2309.DOI:10.1007/s00330-015-3643-1.
[10]Muhib S,Fujino T,Sato N,et al.Epicardial adipose tissue is associated with prevalent atrial fibrillation in patients with hypertrophic cardiomyopathy[J].Int Heart J,2013,54(5):297-303.
[11]Noyes AM,Dua K,Devadoss R,et al.Cardiac adipose tissue and its relationship to diabetes mellitus and cardiovascular disease.[J].World J Diabetes,2014,5(6):868-876.DOI:10.4239/wjd.v5.i6.868.
[12]祁荣兴,李敏,龚沈初,等.64层螺旋CT测量心外膜脂肪体积:对测量结果的可重复性研究[J].放射学实践,2012,27(8):840-843.DOI:10.3969/j.issn.1000-0313.2012.08.007.